Healthcare Provider Details

I. General information

NPI: 1396153581
Provider Name (Legal Business Name): PRINCESS S HOPKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 CALIFORNIA AVE STE 210B
BAKERSFIELD CA
93309-7080
US

IV. Provider business mailing address

4900 CALIFORNIA AVE STE 210B
BAKERSFIELD CA
93309-7080
US

V. Phone/Fax

Practice location:
  • Phone: 661-601-9534
  • Fax:
Mailing address:
  • Phone: 661-601-9534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberCPT-02233763
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: